Today’s Top Story

Survey identifies barriers to adoption of value-based payments

A report released by the American Academy of Family Physicians suggests that, despite progress, serious barriers may slow the adoption of value-based payment systems. The survey of family physicians notes the following factors:

  • lack of staff time to implement care functions that support value-based payment
  • no uniform payer reports on performance
  • lack of standardization of performance measures and metrics
  • unpredictability of revenue stream

In addition, the survey finds that 31 percent of respondents didn’t know how value-based payments were distributed within their practices, while 18 percent said the payments were funneled through administration and not directly distributed to physicians.

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Other News

Study: What factors are associated with liability cases following incidental durotomy linked to spine surgery?

A study published online in the journal Spine analyzes medical liability claims associated with incidental durotomy. The researchers conducted a retrospective cohort study of 48 dural tear-related medical liability cases. They found that 56.3 percent resulted in a ruling in favor of the defendant physician. Among cases involving a payment, the average payment was $2,757,298 in 2016-adjusted dollars. The researchers note that 86.7 percent of cases alleged neurological deficits, and that 83.3 percent of cases without neurological sequelae produced an outcome in favor of the defendant. Overall, additional surgery was required in 56.3 percent of cases, a delay in diagnosis or treatment of durotomy was present in 43.8 percent, and alleged improper durotomy repair was present in 22.9 percent. A favorable outcome for the plaintiff occurred in 61.9 percent of cases with alleged delay in diagnosis or treatment, compared to 29.6 percent of cases lacking such a delay.

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Study: Opioid use prior to discharge suggests guideline to postdischarge prescribing

Data from a study published online in the Journal of the American College of Surgeons suggest that surgical patients’ postdischarge opioid use may be predicted by usage the day prior to discharge. The authors reviewed information on 33 opioid naïve inpatients discharged to home following various surgical procedures. They found that, among patients discharged after postoperative day 1, the number of opioid pills used at home was associated with the number taken the day before discharge and patient age, but not type of surgery. The authors write that 85 percent of patients’ home opioid requirements would be satisfied using the following guideline: If no opioid pills are taken the day before discharge, no prescription is needed; if 1 to 3 opioid pills are taken the day before discharge, a prescription for 15 opioid pills should be given at discharge; if 4 or more pills are taken the day before discharge, then a prescription for 30 opioid pills should be given at discharge. They estimate that adoption of such guidelines would reduce by 40 percent the number of opioid pills prescribed.

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Study: Genetics linked to delay of puberty may impact bone density later in life

According to a study published online in The Journal of Bone and Mineral Research, the timing of puberty may affect areal bone mineral density (aBMD) in a skeletal site- and sex-specific manner that tracks throughout life. Members of the research team constructed sex-specific polygenic risk scores of 333 genetic variants linked to later puberty in European-descent children participating in the Bone Mineral Density in Childhood Study. In a Mendelian randomization framework, they noted that puberty-delaying risk score supported a causal association with lower lumber spine and femoral neck aBMD in adults of both sexes.

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Study: Younger physicians may draw more unsolicited patient complaints

A study published online in the journal JAMA Ophthalmology suggests that compared to younger physicians, older physicians may be less likely to receive unsolicited patient complaints (UPCs). The researchers conducted a retrospective cohort study of 1,342 attending ophthalmologists and neuro-ophthalmologists with a median age of 47 years. At mean 9.8-year follow-up, they found that those older than 70 years had the lowest complaint rate (0.71 complaints per 1,000 follow-up days), while those aged 41 to 50 years had the highest (2.02 per 1,000 follow-up days). Compared with providers aged 71 years or older, providers aged 41 to 50 years saw a 1.73 times higher risk of incurring a UPC and providers aged 31 to 40 years saw a 2.36 times higher risk of incurring a UPC.

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Your AAOS

Still time to submit abstracts for two upcoming symposia

Dec. 8, 2017, is the last day to submit abstracts for two upcoming symposia The AAOS/Orthopaedic Research Society The Physis: Fundamental Knowledge to a Fantastic Future through Research Symposium will be held Feb. 7–9, 2018, in Rosemont, Ill. Organizers are seeking abstracts on research addressing growth plate function, regulation, or novel treatments for physeal disorders. Selected young investigators will receive airfare, lodging, and meals at the event, and will present a poster during a dedicated poster session. In addition, authors of five selected abstracts will be invited to give a podium presentation.

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The AAOS Optimizing Clinical Use of Biologics in Orthopaedic Surgery Research Symposium, will be held Feb. 15–17, 2018, in Stanford, Calif. AAOS is seeking abstracts in the area of biologics, including platelet rich plasma, minimally manipulated adult progenitor cells, tendinopathy, or tissue repair. Selected young investigators will receive airfare, lodging, and meals at the event, and will present a poster during a dedicated poster session.

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Call for volunteers: CMS project on DDS model

AAOS seeks one member to consult with Mathematica Policy Research, Inc. on their U.S. Centers for Medicare & Medicaid Services (CMS) project on the Direct Decision Support (DDS) model. The DDS model will test an approach to shared decision making provided outside of the clinical delivery system by decision support organizations—organizations that provide health management and decision support services. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, and a 100-word biography. All supporting materials must be submitted to Kyle Trivedi by Dec. 10, 2017, at 11:59 p.m. (CT), at:

trivedi@aaos.org

Learn more and submit your application…